Individual
MS. CHARLENE THERESA CONDOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
2529 S 1ST ST, AUSTIN, TX 78704-5466
(512) 978-9500
(512) 901-9708
Mailing address
2529 S 1ST ST, AUSTIN, TX 78704-5466
(512) 978-9500
(512) 901-9708
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP119340
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2187783
—
TX
Enumeration date
08/31/2010
Last updated
03/01/2022
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